Guidance
This guideline covers assessment, management and preventing recurrence for children, young people and adults who have self-harmed. It includes those with a mental health problem, neurodevelopmental disorder or learning disability and applies to all sectors that work with people who have self-harmed.
In this guideline, self-harm is defined as intentional self-poisoning or injury, irrespective of the apparent purpose. The guideline does not cover repetitive, stereotypical self-injurious behaviour (such as head banging).
Last reviewed: 16 August 2024
We simplified the guideline by removing recommendations on general principles of care that are covered in other NICE guidelines (for example, the NICE guideline on service user experience in adult mental health). This is a presentational change only, and no changes to practice are intended.
This guideline updates and replaces NICE guideline CG16 (published July 2004) and NICE guideline CG133 (published November 2011).
Next review: This guidance will be reviewed if there is new evidence that is likely to change the recommendations.
Recommendations
This guideline includes recommendations on:
- information and support
- consent and confidentiality
- safeguarding
- involving family members and carers
- psychosocial assessment and care by mental health professionals
- risk assessment tools and scales
- assessment and care by healthcare professionals and social care practitioners
- assessment and care by professionals from other sectors
- admission to and discharge from hospital
- initial aftercare after an episode of self-harm
- interventions for self-harm
- supporting people to be safe after self-harm
- safer prescribing and dispensing
- training and supervision
Who is it for?
- Healthcare professionals and social care practitioners, commissioners and providers
- Staff in educational settings
- Third sector organisations
- The criminal justice system
- People using self-harm services, their families and carers
Guideline development process
How we develop NICE guidelines
Your responsibility
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.